This article originally appeared in the National Post.
By Nigel Rawson and John Adams, July 18, 2025
The Trudeau government introduced the Canadian Dental Care Plan (CDCP) for Canadians without dental insurance and the framework for a national pharmacare plan to help Canadians pay for prescription medicine. Prime Minister Mark Carney has stated that his government will retain both programs, but are they what Canadians want or need?
Dental associations have expressed concern about the CDCP’s administrative burden and sustainability. The plan covers some services for families with an annual net income under $70,000. Families earning between $70,000 and $90,000 pay 40 to 60 per cent of treatment costs.
However, only fees for a designated list of services are covered based on a federal schedule that often pays less than dentists charge in some provinces, requiring patients to pay the balance. Many Canadians are unaware of these limitations.
Dentists also say the CDCP’s current structure is unsustainable. Ottawa allocated $13 billion to cover around nine-million Canadians over five years, or less than $290 for each eligible Canadian per year.
But the health minister reportedly said that patients saved an average of $850 through the program, implying a cost of $38 billion over five years. And millions more Canadians could become eligible because employers are starting to see the CDCP as an opportunity to save money by cancelling employees’ private dental coverage.
Two points are clear. First, instead of Ottawa saying the CDCP is a subsidy, many Canadians have been led to believe it offers full and free coverage. Second, it would appear as though the CDCP is under-funded by the federal government.
Likewise, the Pharmacare Act came into law in October 2024 after years of opinion polls repeatedly demonstrating support among Canadians for a national plan to provide coverage for those with no prescription drug insurance and to reduce or eliminate the differences between provincial drug plans.
Starting small, the federal government is providing $1.5 billion over five years to cover contraceptives and diabetes medications. Yet the Parliamentary Budget Officer estimates that this initial phase will increase federal spending by $1.9 billion over five years, and that assumes that private and provincial plans maintain their coverage levels. Clearly, the government is also under-funding national pharmacare.
The Advisory Council on the Implementation of National Pharmacare recommended that national pharmacare be based on the same principles as medicare: universality, comprehensiveness, accessibility, portability and public administration.
These principles should mean that any Canadian who requires a medicine is able to access it when they need it without being restricted by unnecessary rules and regulations, inhibited by cost or rationed according to where they live.
However, diabetes medication coverage is limited to predominantly older, inexpensive drugs. Newer drugs, such tirzepatide (which directly treats Type 2 diabetes) and finerenone (which addresses some of its most serious side effects) are excluded — despite having been shown to reduce the risk of heart attacks, strokes and end-stage kidney disease in diabetics.
Furthermore, only British Columbia, Manitoba, Prince Edward Island and the Yukon have so far signed the necessary bilateral agreements with Ottawa for national pharmacare. Alberta and Quebec have indicated that they have no interest in the program, although both want their share of the money dangled by the federal government.
When national pharmacare coverage is only available in some jurisdictions and restricted to older, inexpensive drugs, patients living in provinces that refuse to join the program will have better access to medications than those in jurisdictions that have signed on. This will not only perpetuate current differences between provincial drug plans, it will exacerbate them.
The situation could become even worse if more drug types are eventually included in national pharmacare and employers see the expansion as a chance to save money by cancelling employees’ private drug insurance coverage.
As presently implemented, dental care and pharmacare satisfy few Canadians’ expectations or needs. Ottawa should be transparent with Canadians about its objectives for the CDCP and national pharmacare.
Instead of funding a national pharmacare program that fails to fill the gaps, a better way forward would be for Ottawa to transfer that money to provincial governments. The provinces should then use those funds to level up their coverage to that of the best available provincial plan in the country, and exempt lower-income Canadians from co-payments.
Nigel Rawson is a senior fellow at the Macdonald-Laurier Institute.
John Adams is co-founder and CEO of Canadian PKU and Allied Disorders Inc., and a senior fellow at the Macdonald-Laurier Institute.
